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1.
China Pharmacy ; (12): 230-235, 2022.
Article in Chinese | WPRIM | ID: wpr-913116

ABSTRACT

OBJECTIVE To compare the anticoagulant effectiveness and safety of new oral anticoagulants (NOACs)and warfarin after heart valve replacement ,and to provide evidence-based reference for clinical drug use. METHODS Retrieved from PubMed,Cochrane Library ,Embase,Web of Science ,CNKI,Wanfang database and VIP ,clinical studies about the use of NOACs versus warfarin after heart valve replacement were collected during the inception to July 2021. After literature screening and data extrac tion,the quality of included randomized controlled trials (RCTs)were evaluat ed by bias risk assessment tool recommended by Cochrane system evaluator manual 5.2.0. After the quality of the included cohort studies was evaluated by Newcastle-Ottawa scale (NOS),RevMan 5.3 software was used for meta-analysis and sensitivity analysis. RESULTS A E-mail:carolmeng_0813@163.com total of 9 studies involving 4 962 patients were included ,of which 7 were RCTs and 2 were cohort studie s. Results of meta-analysis showed that after biological valve replacement/repair ,the incidence of stroke and systemic embolism (SSE)[OR=0.71,95%CI(0.52,0.97),P=0.03],major bleeding [OR =0.40,95%CI (0.30,0.54),P<0.000 01] and intracranial hemorrhage [OR =0.20,95%CI(0.04,0.95),P=0.04] in trial group were significantly lower than warfarin group ;there was no significant difference in all-cause mortality between 2 groups [OR =1.25,95%CI(0.88, 1.79),P=0.22]. After mechanical valve replacement/repair ,there were no significant difference in the incidence of SSE [OR =1.52, 95%CI(0.04,60.29),P=0.82] or all-cause mortality [OR =0.26,95%CI(0.04,1.84),P=0.18] between 2 groups. The results of subgroup analysis according to the follow-up time showed that after biological valve replacement/repair ,the incidence of SSE in trial group was significantly lower than that in control group when the follow-up time was ≤3 months [OR =0.20,95%CI(0.06, 0.74),P=0.03];but there was no significant difference in the incidence of major bleeding between 2 groups [OR =0.67,95%CI (0.19,2.38),P=0.53];when the follow-up time was longer than 3 months,there was no statistical significance in the incidence of SSE between 2 groups [OR =0.74,95%CI(0.54,1.02),P=0.07],while the incidence of major bleeding in trial group was significantly lower than control group [OR =0.39,95%CI(0.29,0.52),P<0.001]. Subgroup analysis by study type showed that after biological valve replacement/repair ,the incidence of SSE in the RCT in trial group was significantly lower than that in control group [OR =0.51,95%CI(0.29,0.92),P=0.03],but there was no significant difference in the incidence of major bleeding between 2 groups[OR=0.58,95%CI(0.33,1.03),P=0.06]. In cohort study ,there was no significant difference in the incidence of SSE between 2 groups [OR =1.03,95%CI(0.40,2.66),P=0.95],while the incidence of major bleeding in trial group was significantly lower than control group [OR =0.20,95%CI(0.06,0.74),P<0.001]. Sensitivity analysis results showed that the results of the above-mentioned meta-analysis were relatively robust. CONCLUSIONS For the patients underwent biological valve replacement/repair,the effectiveness and safety of NOACs are better than or similar to those of warfarin ;for the patients underwent mechanical valve replacement/repair ,there is no significant difference in the effectiveness and safety between NOACs and warfarin.

2.
Article in Chinese | WPRIM | ID: wpr-912479

ABSTRACT

Objective:The whole-genome sequencing and virulence characteristics analysis of a Klebsiella pneumoniae isolate that caused lower limb gas gangrene were performed to provide a reference for the comprehensive understanding of molecular virulence characteristics of K. pneumoniae causing severe community-acquired infection. Methods:The patient was admitted to the emergency department for treatment on March 13, 2018.The main clinical symptoms of the patients were high fever, gas gangrene of the left lower limb, and diabetic ketoacidosis. The pus specimen was collected for the bacterial culture, isolates identification and antimicrobial susceptibility testing. Hypermucoviscous phenotype was detected by string test. The whole genome of the isolate was sequenced and the multi-site sequence typing, capsular serotyping, plasmid characteristics, virulence and antimicrobial resistance genes of the isolate were analyzed. Plasmid curing and conjugation experiments were used to analyze plasmid characteristics. The virulence of the strain was assessed by serum killing and Galleria mellonella lethality assays. A two-sample t-test was used to compare the differences in the lethal dose of 50% (LD 50) between the tested strains and reference strains against the G. mellonella larvae. Results:K. pneumoniae strain KPN41053 was identified, it was only resistant to ampicillin and was negative for hypermucoviscous phenotype. Whole genome sequencing showed that the length of KPN41053 chromosome was 5 377 071 bp, belonging to ST660 type, and the capsular type was K16. A IncFIB(K)/HI1B virulence plasmid (207 506 bp) with a sequence that was highly similar to pLVPK was harbored by KPN41053. The plasmid carried a variety of virulence genes, among which rmpA and rmpA2 were pseudogenes. The plasmid could not be transferred horizontally by conjugation. The variation strain KPN41053_PC was obtained by plasmid curing. Serum killing analysis showed that KPN41053 was serum resistant (Grade 6), and KPN41053_PC was serum intermediately sensitive (Grade 3). The lgLD 50 of KPN41053 had no difference with that of the hypervirulent control strain (ST23-K1 type) ( t=0.32, P=0.765), and was significantly lower than that of KPN41053_PC ( t=5.97, P=0.004). Conclusions:KPN41053 was an atypical hypervirulent K. pneumoniae that belonged to ST660 but without a hypermucoviscous phenotype. The virulence plasmid harbored by KPN41053 was its key virulence factor. Hypervirulent K. pneumoniae can lead to community-acquired gas gangrene in diabetic patient, which deserves clinical attention.

3.
Chinese Journal of Orthopaedics ; (12): 1275-1282, 2021.
Article in Chinese | WPRIM | ID: wpr-910716

ABSTRACT

Objective:To investigate the clinical features and treatment strategies of infection after lumbar transpedicular dynamic stabilization.Methods:A total of 1 623 cases with lumbar transpedicular dynamic stabilization conducted from January 2010 to June 2020 were retrospectively analyzed, including 854 males and 769 females and aged 47.56±12.76 years old. There were 1 150 cases with Dynesys fixation, 235 cases with K-Rod, 181 cases with Isobar, 52 cases with Fule and 5 cases with Waveflex. The primary diseases were as following, 984 cases (60.63%) with lumbar disc herniation, 280 cases (17.25%) with lumbar spinal stenosis, 174 cases (10.72%) with lumbar spondylolisthesis, 98 cases (6.04%) with lumbar degenerative scoliosis and 87 cases (5.36%) with discogenic low back pain. Some baseline indicators, such as the overall incidence of infection, the age, gender, smoking, drinking, diagnosis, previous operation history, concomitant disease, the number of fenestration, the number of discectomy, the number of fixed segments, operation duration, blood loss, blood transfusion, the number of the dura mater rupture, postoperative infection duration from primary operation, inflammation indicators (leukocytes, neutrophils, C-reactive protein, erythrocyte sedimentation rate and procalcitonin) of the infected patients, were recorded. According to the time when the infection occurred, the cases were divided into the early infection group (within 3 months after surgery) and the late infection group (more than 3 months after surgery). The clinical indicators and treatment strategies were compared between the two groups.Results:The overall infection rate was 1.66% (27/1 623), including 2.17% (25/1 150) in Dynesys fixation, 1.92% (1/52) in Fule fixation and 0.55% (1/181) in Isobar fixation. The follow-up duration was 51.89±32.55 months. The number of fenestrations was 1(1, 2). The number of discectomy was 1(1, 2), and that of fixed segments was 2(1, 3). The operation duration was 186.30±81.33 minutes, with the blood loss 200 (200, 500) ml and the blood transfusion volume 0(0, 345) ml. There was 1 case of cerebrospinal fluid leakage in early infection group. Thirteen cases of pathogenic bacteria were identified, included 5 cases of Staphylococcus epidermidis, 2 cases of Staphylococcus aureus and 1 case each of Salmonella, Escherichia coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Acinetobacter baumannii, and Streptococcus lactis. A total of 21 patients underwent secondary surgery, including 10 cases of debridement and suturing, 2 cases of internal fixation replacement and 9 cases of internal fixation removal. The other 4 cases underwent puncture and irrigation, while 2 cases received only antibiotic treatment. There were 16 cases with early infection and 11 cases with late infection. There were no significant differences between the two groups in the number of fenestrations, discectomy, operation duration, blood loss, and blood transfusion ( P>0.05). The inflammation indexes of early infection group were higher than those of late infection group with significant difference ( P<0.05), except for procalcitonin. The detection rates of pathogenic bacteria in early and late infection group were 62.5% (10/16) and 27.3% (3/11), respectively. The main infection sites in early infection group were the incision (50.0%, 8/16) and around the internal fixation (18.8%, 3/16). However, the main infection sites in late infection group were around the internal fixation (90.9%, 10/11). In the early infection group, the main treatments including debridement and suturing were conducted in 9 cases, puncturing in 2 cases and internal fixation replacement in 2 cases. In the late infection group, internal fixation removal was performed in 8 cases and puncturing in 2 cases. Conclusion:The overall infection rate after lumbar transpedicular dynamic stabilization was 1.66%. The incidence of early infection was 0.99%, while that of late infection was 0.68%. The incidence of Dynesys fixation was 2.17%. In early infection, the internal fixation could be retained through some treatments as debridement and internal fixation replacement. In most late infection cases, removal of the internal fixation could be helpful to control the infection.

4.
Chinese Journal of Orthopaedics ; (12): 1217-1226, 2021.
Article in Chinese | WPRIM | ID: wpr-910710

ABSTRACT

Objective:To compare the clinical effects of discectomy combined with transpedicular dynamic stabilization and transforaminal lumbar interbody fusion (TLIF) in treating single-level lumbar disc herniation.Methods:From November 2012 to November 2015, a total of 96 patients with single-level lumbar disc herniation (disc height decreased more than 1/3, the width of the basilar part of the herniated disc >6 mm, massive disc herniation or Modic type I endplate changes) treated by discectomy combined with Dynesys dynamic stabilization (Dynesys group, n=48) or TLIF (fusion group, n=48) were enrolled. Clinical assessments included operation duration, intraoperative blood loss, MacNab score, visual analogue scale (VAS), Oswestry disability index (ODI) and rate of complications. Radiographs were evaluated for lumbar mobility, intervertebral height, etc. Results:A total of 86 patients were included in the final analysis (44 in Dynesys group and 42 in fusion group) and were evaluated after 5 years follow-up. The operation duration of Dynesys group (159.61±37.29 min) was less than that of the fusion group (177.42±39.90 min) significantly ( t=2.140, P=0.035). Intraoperative blood loss in Dynesys group (151.78±50.88 ml) was less than that in fusion group (197.74±76.55 ml) with significant difference ( t=3.293, P=0.001). At 5 years follow-up, there were 2 cases with screw loosening and 5 cases with adjacent segmental degeneration in Dynesys group without symptom. In fusion group, there were 12 cases with adjacent segmental degeneration and two of them with symptom. There were significant differences in the incidence of adjacent segment degeneration between the two groups ( χ2=4.012, P=0.045). According to the MacNab criteria, excellent or good cases accounted for 95% in Dynesys group and 93% in fusion group without significant differences ( Z=0.425, P=0.671). VAS back, VAS leg and ODI scores were improved significantly in both groups after 2 years and 5 years ( P<0.05). However, there were no significant differences between the two groups ( P<0.05). The activity of the surgical segment was 4.59°±0.48° in Dynesys group and 1.00°±0.42° in fusion group at 5 years after surgery. The height of intervertebral space in Dynesys group decreased from 11.19±2.07 mm before surgery to 9.98±2.02 mm at 2 years after surgery and to 9.86±1.64 mm at 5 years after surgery ( F=6.462, P=0.002). However, there was no statistically significant difference between the 2 and 5 years follow-up ( q=0.415, P>0.05). At 5 years after surgery, the activity of the first proximal segment in the two groups was 9.74°±3.29° and 11.69°±3.89°, respectively ( t=2.514, P=0.014). Conclusion:Both discectomy combined with dynamic stabilization and TLIF can achieve satisfied clinical effects in treating single-level lumbar disc herniation. Dynamic stabilization preserves the intervertebral activity of surgical segments and results in a lower incidence of adjacent segment degeneration compared with that in fusion surgery. Furthermore, discectomy combined with dynamic stabilization is a less invasive intervention with shorter operation duration and less blood loss compared with TLIF.

5.
Chinese Journal of Orthopaedics ; (12): 1175-1179, 2021.
Article in Chinese | WPRIM | ID: wpr-910705

ABSTRACT

Lumbar transpedicular dynamic stabilization is a posterior spine fixation technique that preserves the lumbar function and remedies the loss of function by fixed fusion. It is mainly used in treating lumbar degenerative diseases, including lumbar disc herniation, degenerative spondylolisthesis, severe spinal stenosis and mild/moderate degenerative lumbar scoliosis and so on. Dynamic fixation can unload part of the stress, which could lead to slowing down the degeneration process of the fixed segments. Without bone grafting and waiting for fusion, it is conducive to have rapid postoperative recovery and to avoid fusion failure with reduced internal fixation-related complications. In clinical application, the correct indication selection and the strict contraindication exclusion are the precondition of good curative effects. The midline dorsal incision and Wiltse approach is advisable for the surgery. The pedicle screws were implanted at the bottom of the groove between the superior articular process and the transverse process. Thus, the dynamic rod could be placed on the lateral side of the facet joint, and should be as close as possible to the motion axis of the lumbar spine. More attention should be paid to postoperative functional rehabilitation of lumbar spine. The lumbar transpedicular dynamic stabilization is a promising new concept and technology. However, it is inevitable that there are differences in understanding this topic due to its difference from traditional strategies. Therefore, it is important to actively promote its scientific research and to correct standardized application in clinical practice.

6.
Chinese Journal of Trauma ; (12): 571-576, 2021.
Article in Chinese | WPRIM | ID: wpr-909906

ABSTRACT

The pelvic and acetabular fracture accounts for 3%-8% of all fractures, and is often accompanied with injuries to the bladder, rectum, important nerves and blood vessels. The fatality rate and disability rate are as high as 18%. The treatment of pelvic and acetabular fracture has experienced conservative treatment, surgical treatment and minimally invasive treatment. In recent years, minimally invasive surgery has been widely used in internal fixation of pelvic fracture. The anterior pelvic ring is an important tension bow of the pelvis. For unstable pelvic fracture, the anterior pelvic ring fracture accounts for almost 3/4. The authors review several minimally invasive surgical techniques for anterior pelvic ring fracture, including internal fixation (INFIX), anterior column channel screw internal fixation, pubic symphysis channel screw internal fixation and anterior ring bridge plate osteosynthesis, so as to provide a reference for choice of clinical treatment methods.

7.
Article in Chinese | WPRIM | ID: wpr-909586

ABSTRACT

OBJECTIVE To investigate whether Renqing Changjue has a protective effect on acute respiratory dis?tress syndrome (ARDS) induced by endotoxin lipopolysaccharide (LPS) in rabbits. METHODS Thirty-six healthy male New Zealand white rabbits were randomly divided into six groups: normal control group, model group, dexamethasone group, Renqing Changjue high, middle and low dose group, with six rabbits in each group. LPS was used to replicate the ARDS model after five consecutive days of gavage. Arterial pressure, respiratory rate and anal temperature blood were recorded for arterial blood gas analysis at 0, 0.5, 1, 2 and 4 h, respectively. At the end of the four-hour experiment, rab?bits were killed by bloodletting, and the lung tissue was quickly removed to determine the cytokines, SOD, MDA and pathological examination of rabbit lung. RESULTS Renqing Changjue can significantly reduce the pathological changes of lung in ARDS model group. The expression of AQP1 and MPO in rabbit lung was significantly decreased by immuno?histochemistry (P<0.05) ,reduce the lung wet/dry weight ratio, increase the ratio of PaO2/FiO2, inhibit the release of inflammatory factors and scavenge free radicals and antioxidant effects. CONCLUSION Renqing Changjue can effec?tively protect rabbits with acute respiratory distress syndrome induced by LPS, and may protect the lung by inhibiting the release of cytokines and anti-oxidation.

8.
Article in Chinese | WPRIM | ID: wpr-907341

ABSTRACT

Objective:To investigate the correlation between methylenetetrahydrofolate reductase (MTHFR) gene polymorphism and early neurological deterioration (END) in Han population with acute ischemic stroke in Chengdu area, and the interaction with other traditional risk factors.Methods:Consecutive Han patients with acute ischemic stroke admitted to the Department of Neurology, the Third People's Hospital of Chengdu from January 2017 to June 2019 were enrolled prospectively. Using the candidate gene association study method, MTHFR gene C677T polymorphism was used as a genetic marker to analyze the correlation between END and MTHFR gene polymorphism, and analyze the interaction of gene-END traditional risk factors.Results:A total of 434 patients with acute ischemic stroke were enrolled in the study, and 129 had END (29.7%). Multivariate logistic regression analysis showed that hyperglycemia (odds ratio [ OR] 2.410, 95% confidence interval [ CI] 1.436-4.046; P<0.001), hyperhomocysteinemia ( OR 2.570, 95% CI 1.229-5.376; P=0.012) and moderate to severe neurological deficit (baseline National Institutes of Health Stroke Scale score >5) ( OR 2.158, 95% CI 1.337-3.484; P=0.002) at admission were independently correlated with END. There was a correlation between C677T polymorphism and END. TT genotype ( OR 1.710, 95% CI 1.021-2.863; P=0.002) and A allele ( OR 1.583, 95% CI 1.181-2.121; P=0.002) could significantly increase the risk of END. Interaction analysis showed that there was interaction effect between C677T polymorphism and hyperglycemia at admission, alcohol drinking and moderate to severe neurological deficit. Interaction could increase the risk of END, but it did not reach statistical significance ( OR 1.237, 95% CI 0.227-6.734; P=0.806). Conclusion:MTHFR gene C677T polymorphism and hyperhomocysteinemia are associated with END in Han population with acute ischemic stroke in Chengdu area.

9.
Article in Chinese | WPRIM | ID: wpr-888041

ABSTRACT

To explore the mechanism of anti-inflammatory and analgesic effect of Zanthoxyli Pericarpium based on network pharmacology and inflammatory or pain mouse models. The effective components of Zanthoxyli Pericarpium were screened out by TCMSP database. And their potential corresponding targets were predicted by PharmMapper software. The possible targets relating to inflammation and pain were mainly collected through DrugBank, TTD and DisGeNET databases. The "active ingredient-gene-disease" network diagram was constructed by Cytoscape 3.7.0 software. The network pharmacology results showed 5 potential effective compounds, which were related to 29 targets; 132 targets relating to inflammation and pain were screened out in the DrugBank, TTD and DisGeNET databases. The network analysis results indicated that the phosphatidylinositol 3-kinase catalytic subunit gamma isoform(PIK3 CG) gene may be the key to the anti-inflammatory and analgesic effect of Zanthoxyli Pericarpium. The anti-inflammatory and analgesic effects of essential oil extract and dichloromethane extract of Zanthoxyli Pericarpium were explored through the mouse model of inflammation induced by xylene or carrageenan and the mouse model of pain induced by acetic acid or formalin. The experimental results showed that essential oil extract and dichloromethane extract of Zanthoxyli Pericarpium could reduce xylene-induced ear swelling and carrageenan-induced paw swelling and decrease the number of writhing responses in mice induced by acetic acid and the licking foot time of mice in phase Ⅱ induced by formalin. Western blot results showed that Zanthoxyli Pericarpium extract could inhibit the expressions of PIK3 CG, phosphonated nuclear factor kappaB(p-NF-κB) and phosphonated p38(p-p38 MAPK) protein. The present study showed the anti-inflammatory and analgesic effect of Zanthoxyli Pericarpium through multiple components and targets, so as to provide a pharmacodynamic basis for the study of Zanthoxyli Pericarpium and its mechanism.


Subject(s)
Analgesics/pharmacology , Animals , Anti-Inflammatory Agents/pharmacology , Drugs, Chinese Herbal , Edema/drug therapy , Inflammation/genetics , Mice , Oils, Volatile , Plant Extracts
10.
Chinese Journal of Neurology ; (12): 441-448, 2021.
Article in Chinese | WPRIM | ID: wpr-885442

ABSTRACT

Objective:To investigate the association of plasma epoxyeicosatrienoic acids (EETs) with early neurological deterioration (END), and whether EETs are mediated by EPHX2 gene variants in patients with minor ischemic stroke (MIS).Methods:This is a prospective, multi-center observational study in patients with acute MIS in the Chinese population. Acute MIS patients with the first onset and onset within 24 hours who were admitted to Deyang People′s Hospital, the Second Affiliated Hospital of Wenzhou Medical University and the Third Affiliated Hospital of Wenzhou Medical University from March 2013 to June 2015 were recruited. Plasma EETs levels were measured on admission. Single nucleotide polymorphisms of EPHX2 gene rs751141 were genotyped using mass spectrometry. The primary outcome was END within 10 days after admission. END was defined as an increase in National Institutes of Health Stroke Scale score of 2 or more points.Results:A total of 322 patients were enrolled, of which 85 (26.4%) patients experienced END. EETs levels were significantly lower in patients with END [(60.3±7.3) nmol/L] compared to patients without END [(68.4±8.1) nmol/L , t=8.464, P<0.001]. Frequency of EPHX2 gene rs751141 GG was higher in patients with END [66/85(77.6%)] than in patients without END [123/237(51.9%),χ2=17.130, P<0.001], and patients with EPHX2 gene rs751141 GG genotype showed lower EETs levels [GG: (59.6±7.8) nmol/L, AG:(67.9±8.2) nmol/L, AA:(68.8±3.2) nmol/L, F=9.285, P<0.001]. Low level (≤64.3 nmol/L) of EETs was an independent predictor of END (31.5-51.3 nmol/L group: OR=2.96,95% CI 1.18-8.77, P=0.02; 51.4-64.3 nmol/L group: OR=2.46,95% CI 1.06-6.89, P=0.03) in multivariate analyses. END was associated with a higher risk of poor outcome (modified Rankin Scale scores 3-6) at 3 months ( OR=1.82,95% CI 1.46-2.35, P=0.02). Conclusion:END is fairly common and associated with poor outcomes in acute MIS. EPHX2 gene variants may mediate EETs levels, and low levels of EETs are related to END in acute MIS.

11.
Article in Chinese | WPRIM | ID: wpr-880829

ABSTRACT

OBJECTIVE@#To establish a mouse model bearing orthotopic temozolomide (TMZ)-resistant glioma that mimics the development of drug resistance in gliomas @*METHODS@#Seventy-eight adult C57BL/6 mice were randomly divided into 6 groups (@*RESULTS@#The mouse models bearing TMZresistant glioma was successfully established. The cells from the high-dose induced group showed a significantly higher colony-forming rate than those from the high-dose control group (@*CONCLUSIONS@#Progressive increase of TMZ doses in mice bearing orthotopic gliomas can effectively induce TMZ resistance of the gliomas.


Subject(s)
Animals , Antineoplastic Agents, Alkylating/pharmacology , Brain Neoplasms/drug therapy , Cell Line, Tumor , Disease Models, Animal , Drug Resistance, Neoplasm , Glioma/drug therapy , Mice , Mice, Inbred C57BL , Temozolomide/therapeutic use
12.
Article in Chinese | WPRIM | ID: wpr-868523

ABSTRACT

Objective:To improve the radionuclide measurement technology by γ-spectrometry throuth a review of the intercomparisons between China and Japan results over the past 20 years.Methods:Before the beginning of each intercomparison, one of participating laboratories was agreed to be responsible for preparing the samples for the intercomparison. By intercomparison of the measurement results arnong the laboratories some potential problems during the sample pre-trement or analysis were found and solved.Results:The intercomparisons had been carried out for 11 times over the past 20 years. Totally 290 measured and analyzed results had been obtained from 20 samples of six categories. The proportion 95.5% of measurement results were in agreement with each other within the deviation range.Conclusions:The measuring and analytical capability of the laboratories involved were tested. The intercomparisons also provide long-term quality assurance measures for the radionuclide measurement and analysis in each laboratory.

13.
Chinese Journal of Trauma ; (12): 714-719, 2020.
Article in Chinese | WPRIM | ID: wpr-867768

ABSTRACT

Objective:To investigate the effect of modified fluoroscopic monitoring in the treatment of acetabular anterior column fractures with percutaneous retrograde screw fixation under computer-assisted 3D navigation.Methods:A retrospective case series analysis was performed on the clinical data of 42 patients with acetabular anterior column fractures admitted to Central Theater Command General Hospital of PLA from December 2013 to December 2016. There were 24 males and 18 females, with the age of 20-61 years [(41.6±12.9)years]. All patients underwent percutaneous retrograde acetabular anterior column screw fixation under computer-assisted 3D navigation. A total of 61 screws were inserted. The observation indexes included the time for insertion of each screw, intraoperative bleeding volume, fluoroscopy time, coincidence rate between intraoperative fluoroscopy and postoperative imaging, and complications. The D'Aubigné-Postel system was used to evaluate the hip joint function at postoperative 6 months. Fracture healing and complications were detected at postoperative 12 months.Results:All patients were followed up for 9-18 months [(13.1±3.2)months]. Time for insertion of each screw was (18.7±4.8)min, intraoperative bleeding volume was (16.6±3.8)ml, fluoroscopy time was (25.3±10.9)s, and coincidence rate between intraoperative fluoroscopy and postoperative imaging was 100%. There were no complications such as neurovascular injury, thrombosis, wound infection, heterotopic ossification and long-term pain. Six months after operation, D'Aubigné-Postel function score was (10.7±0.9)points, significantly improved compared with preoperative (8.7±1.6)points ( P<0.05). Two patients (3 screws) had lower limb mobility and two patients (2 screws) had screw loosening. Conclusion:For acetabular anterior column fractures, percutaneous retrograde acetabular anterior column screw placement assisted by 3D navigation is helpful to improve the accuracy of screw insertion, decrease introperative fluoroscopy time, reduce operation risk, improve screw coincidence rate, and therefore improve hip function.

14.
Article in Chinese | WPRIM | ID: wpr-849609

ABSTRACT

Objective: To investigate the effect of Inula britannica flower total flavonoids (IBFTF) on the expression of lncRNA TERRA in the senile skin fibroblasts and its mechanism. Methods: High performance liquid chromatography (HPLC) was used to analyze the composition and content of IBFTF. The human skin fibroblasts cell line was divided into control group, IBFTF group (cells were treated with IBFTF alone), cell senescence model group [cell senescence model was induced by D-galactose (D-gal)] and cell senescence model + IBFTF group (cell senescence model was treated with IBFTF). The cell viability was detected by CCK-8. The senescence-associated β-galactosidase (SA-β-Gal) staining was used to detect the positive rate of human skin fibroblasts cells, and the contents of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were detected by enzyme microplate reader. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the expression of lncRNA TERRA, hTERT mRNA and the relative length of telomere in the cells. The protein expression of agingrelated proteins such as p53, p16 and human telomerase reverse transcriptase (hTERT) were detected by Western blotting. Results: The contents of quercetin, isorhamnetin, kaempferol and rutin in IBFTF were 6.447, 2.044, 1.272, 0.781 mg/g, respectively. CCK-8 and SA-β-Gal staining showed that IBFTF increased the viability of cells in senescence model group, and reduced the proportion of SA-β-Gal positive cells (P<0.05). Enzyme labeling results showed that IBFTF increased the activity of SOD and GSH-Px, and reduced the MDA level of senescent cells (P<0.05). qRT-PCR showed that IBFTF decreased the expression of lncRNA TERRA, increased the expression of hTERT mRNA and prolonged the telomere length in senescent cells (P<0.05). Western blotting results showed that, compared with cell senescence model group, the protein expressions of p53, p16 decreased, and the hTERT increased in cell senescence model + IBFTF group (P<0.05). Conclusions: IBFTF can decrease the expression of lncRNA TERRA in D-galinduced senescent human skin fibroblasts cells, and its mechanism may be related to the recovery of telomerase activity and the prolongation of telomere length, so as to achieve the effect of delaying senescence.

15.
Journal of Medical Postgraduates ; (12): 689-695, 2020.
Article in Chinese | WPRIM | ID: wpr-822585

ABSTRACT

ObjectiveMild hypothermia was an effective way of cerebral resuscitation after cardiac arrest. The expression of cold-induced RNA binding protein (CIRP) was significantly enhanced when the temperature was lowered. This study was to evaluate the effects and the mechanisms of CIRP inhibition on hippocampal neurological and mitochondria function after mild hypothermia in a rat model of cardiac arrest.MethodsFive male Sprague-Dawley rats were injected with AAV9 in the hippocampus, 1 μL on each side, speeding 0.2 μL/min. The expression of GFP was observed by fluorescence microscopy after 2w. Sixty rats were randomly divided into 5 groups (n= 12 for each group): sham operation group, model group, mild hypothermia group, mild hypothermia + CIRP inhibition group and mild hypothermia + normal control group. Injection of AAV9 was performed on mild hypothermia + CIRP inhibition group, same amount of empty vector on mild hypothermia + normal control group, while normal saline on the other groups. Animal models of global cerebral IR were established by transesophageal cardiac pacing inducing cardiac arrest followed by cardiopulmonary resuscitation at 2w after injection. Cooling to 32-34℃ was initiated and the temperature was maintained for 6h on mild hypothermia groups. NDS score, HE staining and pyramidal cell counting on hippocampal CA1 area were performed at 72h after reperfusion. At 24h after reperfusion, mitochondrial structure of pyramidal cells in hippocampal CA1 was observed under electronic microscope and the expressions of CIRP, dynamin-related protein 1 (Drp1) and cytochrome C (Cyt-C) were detected by Western blot.ResultsThe NDS score of model group was decreased, the number of pyramidal cells was reduced, and the mitochondria were severely damaged. The NDS score of mild hypothermia group was increased, and the number of pyramidal cells was increased (all P<0.05), and mitochondrial damage was reduced compared with model group. In mild hypothermia + CIRP inhibition group, the NDS score was no significant difference compared with mild hypothermia + normal control group and model group, and the number of pyramidal cells was lower than that in mild hypothermia + normal control group [(27.2±4.9) vs (50.2±4.4), P<0.05], similar to model group (25.2±3.8), the damage of mitochondria was severe. After 2 weeks of AAV9 injection, GFP was widely expressed in the hippocampus. The expression of CIRP in mild hypothermia + CIRP inhibition group was respectively small compared with sham operation group [(0.14±0.03) vs (0.03±0.01),P<0.05], which was successfully inhibited by injection of AAV9. The expression of CIRP in model group (0.25±0.05) was significantly higher than that in sham operation group. The expression of CIRP in mild hypothermia group (0.37±0.08) and mild hypothermia + normal control group (0.39±0.04) were higher than that in model group (all P<0.05). The trends of Drp1 and Cyt-C expression were the same, in model group was higher than that in sham operation group, in mild hypothermia group was lower than that in model group, in mild hypothermia + CIRP inhibition group was higher than in mild hypothermia + normal control group (all P<0.05); There were no significant differences between model group and mild hypothermia + CIRP inhibition group, and between mild hypothermia group and mild hypothermia + normal control group.ConclusionInhibition of CIRP expression in hippocampus can weaken the protective effects of mild hypothermia on neurons in a rat model of cardiac arrest. The mechanism of those effects might be association with mitochondrial division.

16.
Journal of Medical Postgraduates ; (12): 684-688, 2020.
Article in Chinese | WPRIM | ID: wpr-822584

ABSTRACT

ObjectiveTo observe the role of parvalbumin interneuron-mediated disinhibition in the antidepressant effects of ketamine.MethodsForty-eight adult male C57BL/6 mice were randomly divided into the following four groups (n=12): group Saline + Saline (group SS), group LPS + Saline (group LS), group Saline + Ketamine (group SK) and group LPS + Ketamine (group LK). The depression model was established by intraperitoneal injection of LPS (1 mg/kg), and ketamine (10 mg/kg) or physiological saline (equal volume) intraperitoneally injected 20 hours later. Four hours after ketamine administration, the open field test and the forced swimming test were performed. The hippocampus was harvested after the behavioral test. PCR and Western blot were used to detect the expressions of PV and GAD67. Electrophysiology were used to detect the change of miniExcitatory post-synaptic current of pyramidal neurons in hippocampus CA1 region.ResultsCompared with the group SS, the time spent in the center zone of the arena was significantly decreased, the immobility time was significantly increased, the mRNA and protein content of PV were significantly increased, the amplitude and frequency of miniEPSC were significantly decreased in the group LS (P0.05).ConclusionKetamine can exert rapid antidepressant effects by down-regulating the expression of PV and then exerting disinhibition regulation on pyramidal neurons.

17.
Article in English | WPRIM | ID: wpr-829006

ABSTRACT

Objective@#Moxifloxacin (MFX) shows good activity against and can be a possible antibiotic therapy to treat infection; however, other studies have shown a lower or no activity. We aimed to evaluate MFX activity against using zebrafish (ZF) model .@*Methods@#A formulation of labeled with CM-Dil was micro-injected into ZF. Survival curves were determined by recording dead ZF every day. ZF were lysed, and colony-forming units (CFUs) were enumerated. Bacteria dissemination and fluorescence intensity in ZF were analyzed. Inhibition rates of MFX and azithromycin (AZM, positive control) were determined and compared.@*Results@#Significantly increased survival rate was observed with different AZM concentrations. However, increasing MFX concentration did not result in a significant decrease in ZF survival curve. No significant differences in bacterial burdens by CFU loads were observed between AZM and MFX groups at various concentrations. Bacterial fluorescence intensity in ZF was significantly correlated with AZM concentration. However, with increasing MFX concentration, fluorescence intensity decreased slightly when observed under fluorescence microscope. Transferring rates at various concentrations were comparable between the MFX and AZM groups, with no significant difference.@*Conclusion@#MFX showed limited efficacy against using ZF model. Its activity needs to be confirmed.


Subject(s)
Animals , Anti-Bacterial Agents , Pharmacology , Disease Models, Animal , Moxifloxacin , Pharmacology , Mycobacterium Infections, Nontuberculous , Drug Therapy , Mycobacterium abscessus , Zebrafish
18.
Chinese Medical Journal ; (24): 285-291, 2020.
Article in English | WPRIM | ID: wpr-781587

ABSTRACT

BACKGROUND@#The incidence of uterine cesarean scar defect (niche) is high, and some patients require surgery. Single-port laparoscopy can reduce post-operative pain, and provide better cosmetic effects. This study was performed to evaluate the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scar defect (niche) in women after cesarean section.@*METHODS@#This study included 74 patients who were diagnosed with uterine cesarean niche at the Shanghai First Maternity and Infant Hospital from January 2013 to June 2015. Thirty-seven patients underwent single-port laparoscopy-assisted vaginal surgery as the case group, and the remaining patients underwent vaginal repair surgery as the control group. We collected data from the inpatient and follow-up medical records. The clinical characteristics of these two groups were compared. The odds ratios and 95% confidential intervals were calculated for each variable by univariate and multivariate analyses.@*RESULTS@#Patients who underwent single-port laparoscopy-assisted vaginal repair had a significantly longer operation time (2.3 [2.0-2.7] vs. 2.0 [1.6-2.3] h, P = 0.015), shorter gas passage time (1.2 [1.0-1.5] vs. 1.7 [1.0-2.0] days, P = 0.012), shorter hospital stay (3.1 [3.0-4.0] vs. 4.5 [4.0-6.0] days, P = 0.019), and fewer complications (0 vs. 4 cases). Univariate analysis showed that depth of the niche (P = 0.021) the mild adhesiolysis score (P = 0.035) and moderate adhesiolysis score (P = 0.013) were associated with the bladder injury. Multivariate analysis showed that the moderate adhesiolysis score (P = 0.029; 95% confidence interval, 1.318-3.526) was the strongest independent predictor of bladder injury.@*CONCLUSION@#This study confirmed the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scars.

19.
Chinese Medical Journal ; (24): 1807-1814, 2019.
Article in English | WPRIM | ID: wpr-802701

ABSTRACT

Background@#Elderly patients with diffuse large B-cell lymphoma (DLBCL) have a worse prognosis than younger patients, and the optimal treatment strategy for this group remains controversial. We conducted a retrospective analysis to investigate the clinical features and outcomes of elderly patients (>60 years) and to assess the impact of clinical and molecular factors on outcome in this age group.@*Methods@#From April 2006 to December 2012, a total of 349 elderly patients with DLBCL from the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College were included in this analysis. Patients were further divided into two age groups (61–69 years and ≥70 years). We compared clinical characteristics and outcomes between groups.@*Results@#Of 349 total patients, 204 (58.5%) were aged 61 to 69 years, and 145 (41.5%) patients were aged 70 years or older. Except for the Eastern Cooperative Oncology Group performance status, clinical characteristics were comparable between the two groups. With a median follow-up of 82 (range, 1–129) months, the 5-year overall survival (OS) and progression-free survival (PFS) rates were 51.9% and 45.8%, respectively. The 5-year OS rates for patients aged 61 to 69 years and those over 70 years were 58.3% and 42.8% (P = 0.007), respectively, and the 5-year PFS rates were 51.0% and 38.6% (P = 0.034). Treatment regimens including rituximab provided a higher 5-year OS rate (63.1% vs. 37.1%, P < 0.001) and PFS rate (56.6% vs. 31.8%, P < 0.001) than chemotherapy alone. For patients aged 61 to 69 years, chemotherapy plus rituximab resulted in a higher 5-year OS rate (66.7% vs. 46.4%, P = 0.002) and PFS rate (60.0% vs. 38.1%, P = 0.002) than chemotherapy alone. For patients aged ≥70 years, there was a marked survival advantage in patients who received chemotherapy plus rituximab (5-year OS rate: 57.7% vs. 25.4%, P < 0.001; 5-year PFS rate: 51.3% vs. 23.9%, P < 0.001) compared with that seen in those who received chemotherapy alone. Multivariate analysis established that stage III/IV disease, elevated lactate dehydrogenase (LDH), initial treatment, and chemotherapy with rituximab were independent risk factors for 5-year OS, and stage III/IV disease, elevated LDH, and chemotherapy with rituximab were independent risk factors for 5-year PFS for elderly patients with DLBCL.@*Conclusions@#In comparison to patients aged 61 to 69 years, those aged ≥70 years have poorer survival. Prolonged survival is obtainable with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP)-like in elderly Chinese patients in all age groups, indicating that the R-CHOP-like regimen should be considered for this population, even for those aged 70 years or older.

20.
Journal of Chinese Physician ; (12): 1794-1797,1802, 2019.
Article in Chinese | WPRIM | ID: wpr-800559

ABSTRACT

Objective@#To explore the clinical benefits and risks of intravenous thrombolysis combined with urinary kallidinogenase in the treatment of minor stroke.@*Methods@#The clinical data of 86 patients with minor stroke were retrospectively analyzed. Patients who received intravenous thrombolysis combined with urinary kallidinogenase were included in observation group (n=48), and those who received intravenous thrombolysis alone were included in control group (n=38). Before treatment and after 2 weeks of treatment, the imaging blood flow perfusion parameters [cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP)], and breath holding test indexes [cerebral vascular reactivity (CVR), breath holding index (BHI)] and serum biochemical indicators [vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF)] were compared between the two groups. The occurrence of adverse drug reactions during course of treatment and rehabilitation effects at 3 months after treatment [US National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS)] were analyzed in the two groups.@*Results@#After 2 weeks of treatment, the CBF, CVR, BHI and serum levels of VEGF and bFGF in the two groups were significantly higher than those before treatment, and the indexes in observation group were significantly higher than those in control group (P<0.05). The MTT and TTP levels in the two groups were significantly higher than those before treatment, and the levels in observation group were significantly higher than those in control group (P<0.05). There was no significant difference in the incidence rate of adverse drug reactions between the two groups during course of treatment (P>0.05). At 3 months after treatment, there was no statistically significant difference in the effective rate of rehabilitation between the two groups (P>0.05), but the Mann-Whitney U rank sum test between-groups showed that the overall rehabilitation effects in observation group were significantly better than those in control group (P<0.05).@*Conclusions@#Intravenous thrombolysis has certain treatment effects in patients with minor stroke, and its safety is within the clinical controllable range. Combined with urinary kallidinogenase can obtain ideal long-term prognosis, and it is beneficial to the recovery of neurological function.

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